- Is socialized medicine ethical?
- When the Pope recently washed the feet of women on Holy Thursday, does that mean that the liturgical law is changed which prescribes that only men should have their feet washed?
Question: Is socialized medicine ethical?
Answer: The answer to this question depends on the relation of the state to the economy. In the capitalist view, the market must remain free and unfettered by any kind of outside interference so that the law of supply and demand can lead to a growth of capital, which will then provide for businesses to not only insure goods and services, but also just wages for all. Boundless faith in laissez-faire capitalism characterized 19th-century ideas concerning business and trade. The depressed economies, which eventually followed World War I, brought about a conventional wisdom that this sort of capitalism had led to economic destruction. The solution was provided by people like John Maynard Keynes in an influential book he wrote, published in 1923, called Tract on Monetary Reform. This was later followed by the cornerstone of the current theory behind many socialized economies, The General Theory of Employment, Interest, and Money, also published by Keynes in 1936. This introduced the word “Keynesianism” into political and economic theory, and it has been present ever since. Keynes’ economic theory advocated “a ‘managed currency’ and a stabilized price-level, both involving constant government interference, coordinated internationally” (Paul Johnson, A History of the American People, 729). Keynes’ theory encouraged governments to pump money into the economy to stimulate it instead of allowing the market to do so.
Coupled with this government interference was the socialistic idea that government ownership was the best way to ensure that all would be given the goods and services which they needed at a price which they could afford. In the post-World War II climate, many governments adopted a variation of these two models. This was especially true regarding health care in many countries. State interference and state ownership seemed like the ideal way to produce affordable health care. Unfortunately, both of these models are contrary to Catholic social teaching.
In Catholic social teaching, the economic order is an extension of the family, not the state. The purpose of this economic order is to insure that a just wage will be given to support family life, and at the same time, provide small enough social units in the company to make sure that goods and services are properly provided. The market, in general, should drive the just price and wage. However, if these break down, or there is an emergency situation, such as a famine or a war, government may certainly make laws to regulate the economy, or in extreme situations, practice state ownership. But this should only be a temporary situation.
The watchword for everything in the economy is that “small” is beautiful. Mega-states cannot provide truly personal goods and services for too long, as bureaucracies are notoriously inefficient. If they are inefficient when it comes to war and defense, how is it possible that such a bureaucracy can also oversee the running of everything in the country’s economy. Given the necessarily personal nature of health care, this is especially true. On the one hand, this does not mean that government should refuse to ensure that the poor have access to some form of health care, thereby upholding social justice. But on the other hand, it means that it must stop short of government ownership and oversight of all health care. The operative moral principle is that of “subsidiarity.” This principle states that it is wrong for the higher, larger and more complex, community to usurp the rights and duties of the smaller community. The purpose of the higher community is not to absorb the smaller, but to encourage the smaller community, by law, to do what should be done through a more just and responsible approach.
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Question: The Pope recently washed the feet of some women on Holy Thursday. Does this papal action automatically mean that the liturgical law is changed which prescribes that only men should have their feet washed within the context of the liturgy?
Answer: The principles involved in the answer to this question strike at the very heart of the nature of the authority of the papacy. This subject has been treated at length by the First and Second Vatican Councils. The normal term to express this authority is “infallibility.” The pope is, of course, the Vicar of Christ on earth, and, as such, is the supreme authority on earth in the Catholic Church. According to Catholic doctrine, the authority was given by Christ to St. Peter, and his successors, while he was personally present on earth.
Infallibility means that the Church, as a whole, cannot err in believing what Christ taught, either directly, or by logical connection to formal revelation. However, the authorities, which speak for what the Church has always believed, are the pope’s alone when he intends to define a teaching in faith or morals; and the college of bishops, when speaking as a whole. The first is directly taught by Vatican II, and is the result of a charismatic grace which the pope personally exercises in his office as supreme Pontiff. This was defined by Vatican I, and the teaching of the Church on this subject has not changed. “For the Roman Pontiff, by reason of his office as Vicar of Christ, and as pastor of the entire Church, has full, supreme, and universal power over the whole Church, a power which he can always exercise unhindered” (Catechism of the Catholic Church {CCC}, §882; Cf. Lumen Gentium, 22). The second is the college of bishops, which is not a parliament set against the pope, but includes the pope. “The college or body of bishops has not authority unless united with the Roman Pontiff, Peter’s successor, as its head” (ibid.). The pope is the only bishop who has a right to speak for the college as a whole, and there can be no collegial act apart from his approval, or at least his reception. Teachings of the college are also infallible, but they are not the same as the infallibility taught by Vatican I concerning the ability of the pope, alone, to define a doctrine. The infallibility of the college of bishops is taught in Vatican II. Both the ordinary, and the extraordinary, Magisterium exercise teaching in this way. A denial of these teachings would be under the sanction of either formal heresy or schism.
There are also teachings of the Church made “without arriving at an infallible definition and without pronouncing in a ‘definitive manner’” which involve a teaching of the ordinary Magisterium that “leads to a better understanding of Revelation in matters of faith and morals. To this ordinary teaching, the faithful ‘are to adhere to it with a religious assent.’” (CCC §892; Lumen Gentium, 25). Denial of teachings like this would be a sin of disobedience, but not formal heresy.
The practices of the liturgy are not teachings, as such, but are an extension and implementation of faith. Still, if one were to divert from liturgical practice, this would be disobedience and a sin. But unless it involved the matter and form of the sacraments, it would not be heretical or even schismatic. Liturgical practices, outside the issue of form and matter, are human law, not divine or natural law. The only person who could dispense from human law would be the authority who declared and promulgated it. This is the dicastery in Rome, which implements the directions of the pope and, thus, the whole Church, in liturgical practices. Dispensation would normally occur in the law through legal channels, but since the authority who made the law was under papal mandate, the pope could, in prudent circumstances, dispense himself from its observance. This is not a norm for the whole Church anymore, that a given dispensation for an order, or diocese, would involve general law or practice.
In light of these facts, it seems absurd to conclude from an act of a given pope—albeit an act at variance with common law—that this is determinative for the whole Church, unless the pope himself declares he is intending to make this a practice for the whole Church. Those who want to destroy the unity and ritual of the liturgy should not take a given papal action, on a special occasion, as a justification for declaring it a license to do what they want to regarding liturgical practice. By the same token, those who declare that since the Pope did it, the proclaimed norms have been changed, should not take this as a precedent—unless, of course, the Pope himself says it is, or the dicastery in question changes the norm and its language. Regarding this practice of washing the feet of men only during Holy Thursday services: at the time the Pope washed the feet of women as well, the norm on this issue was still sufficiently clear, and so this norm of washing only mens’ feet should continue to be observed unless a dubium (“doubtful question”) is resolved by the Congregation in Rome saying it should not be restricted to men only.
Once again Fr. Mullady’s has responded with a reasoned and precise explanation of a moral issue. His exposition of the moral implications of socialized medicine go to the core of the matter – the practice of medicine is, at its heart, personal. It therefore surely belongs under the principle of subsidiarity; with the reasonable exceptions cited.
I am a long time reader and have appreciated the authors selected for this fine magazine Q&A column.
An interesting pairing of questions. “Men only” is not prescriptive but descriptive. It also describes an action connected with the rite, namely selection. Isn’t it the sort of decision that is better suited to the “smaller community,” the local parish?
Thank you Father Mulady, for this very clear idea showing the facts of economics and medicine. And with Pope Francis washing the feet of women there is the papal magisterium at work where there is no appeal from the pope. This was the Pope’s own action and if he wishes to allow the universal church to do the same it is up to him.
FATHER: I have a problem with Adam and Eve. If they were the first an uniques oure fathers, their sons had incestuous relations, and we are descendantes of them. Conclusion:all we are descendants of ilegitimate relations, or not? Coud you explain this situation?